Surgical access device with rotatably actuated fixation mechanism

ABSTRACT

A surgical access device includes a cannula body and a fixation mechanism. The cannula body includes a housing, and an elongated portion extending distally from the housing and defining a longitudinal axis. The fixation mechanism includes a flange, a fixation sleeve, and a proximal sleeve. The flange is rotatable about the longitudinal axis. The fixation sleeve extends distally from the flange and radially surrounds a portion of the elongated portion of the cannula body. The proximal sleeve extends distally from the flange and radially surrounds a proximal portion of the fixation sleeve. Rotation of the flange causes a radially-expandable portion of the fixation sleeve to move between a first position defining a first gap between the radially-expandable portion and the elongated portion, and a second position defining a second, greater, gap between the radially-expandable portion and the elongated portion.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a continuation of U.S. patent applicationSer. No. 16/784,662, filed on Feb. 7, 2020, the entire contents of whichare incorporated herein by reference.

BACKGROUND Technical Field

The present disclosure relates to a surgical access device. Moreparticularly, the present disclosure relates to a surgical access devicehaving a rotatably actuated fixation mechanism to help maintain itsposition relative to a patient during a surgical procedure.

Background of Related Art

In minimally invasive surgical procedures, including endoscopic andlaparoscopic surgeries, a surgical access device permits theintroduction of a variety of surgical instruments into a body cavity oropening. A surgical access device (e.g., a cannula) is introducedthrough an opening in tissue (i.e. a naturally occurring orifice or anincision) to provide access to an underlying surgical site in the body.The incision is typically made using an obturator having a blunt orsharp tip that has been inserted within the passageway of the surgicalaccess device. For example, a cannula has a tube of rigid material witha thin wall construction, through which an obturator may be passed. Theobturator is utilized to penetrate a body wall, such as an abdominalwall, or to introduce the surgical access device through the body wall,and is then removed to permit introduction of surgical instrumentationthrough the surgical access device to perform the surgical procedure.

During these procedures, it may be challenging to maintain the positionof the surgical access device with respect to the body wall,particularly when exposed to a pressurized environment. To help maintainthe position of the surgical access device with respect to the bodywall, an expandable anchor or fixation mechanism disposed near a distalend of the surgical access device is occasionally used. Expanding suchan anchor while the surgical access device is within the body helpsprevent the surgical access device from undesired movement with respectto the body.

Accordingly, it may be helpful to provide a fixation mechanism that isdeployed via rotation of a flange, as opposed to longitudinal movementof a flange, for instance, to help maintain the longitudinal position ofthe surgical access device with respect to the patient.

SUMMARY

The present disclosure relates to a surgical access device including acannula body and a fixation mechanism. The cannula body includes ahousing and an elongated portion extending distally from the housing.The elongated portion defines a longitudinal axis and defines a channelextending therethrough. The fixation mechanism is disposed in mechanicalcooperation with the elongated portion of the cannula body, and includesa flange, a fixation sleeve, and a proximal sleeve. The flange isrotatable about the longitudinal axis relative to the elongated portionof the cannula body. The fixation sleeve extends distally from theflange and radially surrounds a portion of the elongated portion of thecannula body. The fixation sleeve includes a proximal portion, a distalportion, and a radially-expandable portion. The proximal sleeve extendsdistally from the flange and radially surrounds the proximal portion ofthe fixation sleeve. Rotation of the flange about the longitudinal axisrelative to the elongated portion of the cannula body causes theradially-expandable portion of the fixation sleeve to move between afirst position defining a first gap between the radially-expandableportion of the fixation sleeve and the elongated portion of the cannulabody, and a second position defining a second gap between theradially-expandable portion of the fixation sleeve and the elongatedportion of the cannula body. The second gap is greater than the firstgap.

In aspects, the fixation mechanism may include a distal sleeve radiallysurrounding the distal portion of the fixation sleeve.

The radially-expandable portion of the fixation sleeve may be disposedbetween the proximal portion of the fixation sleeve and the distalportion of the fixation sleeve.

In aspects, the radially-expandable portion of the fixation sleeve maybe disposed distally of the proximal sleeve.

Additionally, the fixation mechanism may include a distal sleeveradially surrounding the distal portion of the fixation sleeve. Theradially-expandable portion of the fixation sleeve may be disposeddistally of the proximal sleeve and proximally of the distal sleeve.

In aspects, the fixation sleeve may be made from at least one of mesh ora shape-memory material.

In additional aspects, the proximal sleeve may be made from at least oneof a transparent material or a translucent material. Additionally, thefixation mechanism may include a distal sleeve radially surrounding thedistal portion of the fixation sleeve. The distal sleeve may be madefrom at least one of a transparent material or a translucent material.

In aspects, the surgical access device may include an anchor engagedwith the elongated portion of the cannula body. The anchor may bedisposed proximally of the radially-expandable portion of the fixationsleeve. The anchor may be longitudinally translatable relative to theelongated portion of the cannula body. The anchor may be longitudinallytranslatable relative to the fixation sleeve of the fixation mechanism.

In aspects, the surgical access device may include a distal tip engagedwith a distal end of the fixation sleeve.

In aspects, the elongated portion of the cannula body may include araised stop configured to engage the flange of the fixation mechanism.The raised stop may define an annular shelf. In aspects, the flange maybe movable between a first position where a proximal wall of the flangeis disposed proximally of the annular shelf of the raised stop, and asecond position where the proximal wall of the flange is disposeddistally of the annular shelf of the raised stop. Additionally, rotationof the flange about the longitudinal axis relative to the elongatedportion of the cannula body may cause the flange to move between itsfirst position and its second position.

The present disclosure also relates to a fixation mechanism for use witha surgical access device. The fixation mechanism includes a flange, afixation sleeve, a proximal sleeve, and a distal sleeve. The flangedefines a passageway therethrough, and defines a longitudinal axis. Thefixation sleeve extends distally from the flange and includes a proximalportion, a radially-expandable portion, and a distal portion. Theproximal sleeve extends distally from the flange and radially surroundsthe proximal portion of the fixation sleeve. The distal sleeve radiallysurrounds the distal portion of the fixation sleeve. Rotation of theflange in a first direction about the longitudinal axis causes theradially-expandable portion of the fixation sleeve to move away from thelongitudinal axis.

In aspects, the radially-expandable portion of the fixation sleeve maybe disposed distally of the proximal sleeve and proximally of the distalsleeve.

In aspects, the proximal sleeve and the distal sleeve may be made fromat least one of a transparent material or a translucent material.

In additional aspects, the fixation sleeve may be made from at least oneof mesh or a shape-memory material.

In aspects, the fixation mechanism may include a distal tip secured to adistal end of the fixation sleeve, and secured to the distal sleeve.

DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are illustrated hereinwith reference to the accompanying drawings, wherein:

FIG. 1 is a perspective view of a surgical access device illustrating afixation member in an undeployed configuration;

FIG. 2 is an assembly view of the surgical access device of FIG. 1 ;

FIG. 3 is an enlarged view of the area of detail indicated in FIG. 2 ;

FIG. 4 is a side cross-sectional view of a portion of the surgicalaccess device taken along section line 4-4 in FIG. 3 ;

FIG. 5 is a side cross-sectional view of a flange of the surgical accessdevice taken along section line 5-5 in FIG. 2 ;

FIG. 6 is a longitudinal cross-sectional view of the surgical accessdevice taken along section line 6-6 in FIG. 1 ;

FIG. 7 is an enlarged view of the area of detail indicated in FIG. 6 ;

FIG. 8 is a perspective view of the surgical access device of FIG. 1illustrating the fixation member in a deployed configuration;

FIG. 9 is a longitudinal cross-sectional view of the surgical accessdevice taken along section line 9-9 in FIG. 8 ;

FIG. 10 is an enlarged view of the area of detail indicated in FIG. 9 ;

FIG. 11 is an assembly view of a proximal portion of a surgical accessdevice and a flange according to an additional aspect of the presentdisclosure; and

FIG. 12 is a side cross-sectional view of the flange engaged with aportion of the surgical access device of FIG. 11 .

DETAILED DESCRIPTION

Aspects of the presently disclosed surgical access device will now bedescribed in detail with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews. As is common in the art, the term “proximal” refers to that partor component closer to the user or operator, i.e. surgeon or physician,while the term “distal” refers to that part or component farther awayfrom the user.

Generally, the surgical access device or cannula, often part of a trocarassembly, may be employed during surgery (e.g., laparoscopic surgery)and may, in various aspects, provide for the sealed access oflaparoscopic surgical instruments into an insufflated body cavity, suchas the abdominal cavity. The cannula is usable with an obturatorinsertable therethrough. The cannula and obturator are separatecomponents but are capable of being selectively connected together. Forexample, the obturator may be inserted into and through the cannulauntil the handle of the obturator engages, e.g., selectively locks into,a proximal housing of the cannula. In this initial position, the trocarassembly is employed to tunnel through an anatomical structure, e.g.,the abdominal wall, either by making a new passage through the structureor by passing through an existing opening through the structure. Oncethe trocar assembly has tunneled through the anatomical structure, theobturator is removed, leaving the cannula in place in the structure,e.g., in the incision created by the trocar assembly. The proximalhousing of the cannula may include seals or valves that prevent theescape of insufflation gases from the body cavity, while also allowingsurgical instruments to be inserted into the body cavity.

Additionally, the surgical access device of the present disclosureincludes a fixation mechanism configured to engage tissue to helpmaintain the cannula in its position relative to the body during use.

FIGS. 1-10 illustrate an aspect of a surgical access device according tothe present disclosure. With initial reference to FIG. 1 , the surgicalaccess device 10 includes a cannula body 100 and a fixation mechanism200. The cannula body 100 includes a proximal housing 120 at itsproximal end, and includes an elongated portion 140 extending distallyfrom the proximal housing 120. The elongated portion 140 defines achannel 150 (FIG. 4 ) extending therethrough, and defines a longitudinalaxis “A-A.” An obturator (not shown) is insertable through the channel150 and is engageable with the proximal housing 120, for instance.

With particular reference to FIG. 2 , the fixation mechanism 200 isdisposed in mechanical cooperation with the elongated portion 140 of thecannula body 100, and includes a flange 210, a fixation sleeve 220, aproximal sleeve 230, a distal sleeve 240, an anchor 250, and a distaltip 260.

Referring to FIGS. 1 and 2 , the engagement between the fixationmechanism 200 and the cannula body 100 is shown. The flange 210 ispositioned adjacent a raised stop 142 of the elongated portion 140 ofthe cannula body 100. The fixation sleeve 220 extends distally from theflange 210 and radially surrounds a portion of the elongated portion 140of the cannula body 100. The proximal sleeve 230 radially surrounds aproximal portion 222 of the fixation sleeve 220. The distal sleeve 240radially surrounds a distal portion 224 of the fixation sleeve 220. Inaspects (such as shown in FIG. 1 ), at least portions of the proximalsleeve 230 and/or the distal sleeve 240 are made from a transparent ortranslucent material, such as a plastic film or elastomer, which mayfacilitate a visual inspection of the fixation sleeve 220, for instance.

As discussed below, the fixation sleeve 220 includes aradially-expandable portion 226 disposed between the proximal portion222 and the distal portion 224, and which is not radially surrounded byeither the proximal sleeve 230 or the distal sleeve 240. The anchor 250radially surrounds part of the proximal sleeve 230. The distal tip 260engages a distal end 242 of the distal sleeve 240. Additionally, theflange 210 is secured, e.g., over-molded, to a proximal end 232 of theproximal sleeve 230 and to a proximal end 220 a of the fixation sleeve220, and the distal tip 260 is secured, e.g., over-molded, to a distalend of the distal sleeve 240 and to a distal end of the fixation sleeve220.

The flange 210 is rotatable about the longitudinal axis “A-A” relativeto the elongated portion 140 of the cannula body 100, and islongitudinally translatable relative to the elongated portion 140between a first position where a proximal wall 210 a of the flange 210is disposed proximally of the raised stop 142 (FIGS. 1 and 7 ), and asecond position where the proximal wall 210 a of the flange 210 isdisposed distally of the raised stop 142 (FIGS. 8 and 10 ). Apredetermined amount of rotation of the flange 210 about thelongitudinal axis “A-A” (in the general direction of arrow “B” in FIG. 8) relative to the elongated portion 140 causes the flange 210 to movedistally (in the general direction of arrow “C” in FIG. 8 ) from thefirst position to the second position. Such movement may be enabled orfacilitated by a threaded connection between the flange 210 and theelongated portion 140 of the cannula body 100, and/or by the naturaltendencies of the fixation sleeve 220 to contract as it is rotated. Inembodiments, the fixation sleeve 220 is made from mesh and/or ashape-memory material.

The movement of the flange 210 causes the radially-expandable portion226 of the fixation sleeve 220 to move between a first position (FIGS. 1and 6 ) and a second position (FIGS. 8 and 9 ). In the first position,the radially-expandable portion 226 of the fixation sleeve 220 isnon-expanded such that it is adjacent or in contact with the elongatedportion 140 of the cannula body 100 (FIGS. 1 and 6 ) defining a firstgap between the radially-expandable portion 226 and the elongatedportion 140 of the cannula body 100. With particular reference to FIG. 6, in use, when the radially-expandable portion 226 of the fixationsleeve 220 is in the first position, the distal portion of the elongatedportion 140 of the cannula body 100 (i.e., the portion located distallyof the anchor 250) is insertable into and removable from a tissue cavity“C.”

In the second position, the radially-expandable portion 226 of thefixation sleeve 220 is radially expanded such that it is no longeradjacent or in contact with the elongated portion 140 of the cannulabody 100 (FIGS. 8 and 9 ) defining a second gap between theradially-expandable portion 226 and the elongated portion 140 of thecannula body 100. The second gap is greater than the first gap. Inaspects, the radially-expandable portion 226 may be maintained betweenthe first positon and the second position. With particular reference toFIG. 9 , in use, when the radially-expandable portion 226 of thefixation sleeve 220 is in the second position, the radially-expandableportion 226 is within the tissue cavity “C” and is adjacent a distalportion of a tissue wall “T,” thereby resisting a proximally-directedforce acting on the surgical access device 10.

With particular reference to FIGS. 3-5, 7 and 10 , further details ofvarious features of the fixation mechanism 200 and its engagement withthe cannula body 100 are shown. In FIGS. 3 and 4 , the raised stop 142of the elongated portion 140 of the cannula body 100 is shown. Theraised stop 142 includes an angled or ramped proximal portion 142 a, alinear distal portion 142 b, and an annular shelf 142 c (FIG. 4 )interconnecting the distal portion 142 b and the elongated portion 140.

FIG. 5 illustrates details of the flange 210. As shown, the flange 210is ring-like as it includes an annular wall 212 and defines alongitudinal passageway 214 therethrough. As shown in FIG. 1 , forexample, the annular wall 212 of the flange 210 includes arms 213 tofacilitate manipulation of the flange 210 (e.g., rotation thereof)relative to the elongated portion 140 of the cannula body 100. Thepassageway 214 includes a proximal section 214 a and a distal section214 b. The proximal section 214 a is narrower than the distal section214 b, and a flange ramp 216 on an inner surface of the annular wall 212is disposed between the proximal section 214 a and the distal section214 b of the passageway.

With particular reference to FIGS. 7 and 10 , the engagement between theraised stop 142 of the elongated portion 140 of the cannula body 100 andthe flange 210 is shown. When the flange 210 is in its first position(FIG. 7 ), the proximal wall 210 a of the flange 210 is disposedproximally of the raised stop 142. More particularly, the flange ramp216 is in contact with the ramped proximal portion 142 a of the raisedstop 142. To move the flange 210 distally past the raised stop 142 andinto its second position (FIG. 10 ), a user can either push the flange210 distally relative to the elongated portion 140 (with sufficientforce to overcome the frictional engagement between the flange ramp 216and the ramped proximal portion 142 a of the raised stop 142), or, asdiscussed above, the user can rotate the flange 210 in the firstdirection (e.g., clockwise) about the longitudinal axis “A-A” relativeto the elongated portion 140. Once the flange 210 is in its secondposition (FIG. 10 ), the engagement between the proximal wall 210 a ofthe flange 210 and the annular shelf 142 c of the raised stop 142 helpsmaintain the flange 210 in the second position by resistingproximally-directed forces against the fixation sleeve 220, forinstance. The flange 210 can be returned to its first position byrotating the flange 210 in a second direction (e.g., counter-clockwise)about the longitudinal axis “A-A” relative to the elongated portion 140.

FIGS. 11 and 12 illustrate details of a flange 210′ and an elongatedportion 140′ according to another aspect of the present disclosure. Theflange 210′ and the elongated portion 140′ are configured to work withother elements of the fixation mechanism 200, as discussed above.

The flange 210′ is ring-like as it includes an annular wall 212′ anddefines a longitudinal passageway 214′ therethrough. The annular wall212′ of the flange 210′ includes a plurality of radially-spacedprojections 216′ extending radially inward into the longitudinalpassageway 214′. The projections 216′ are configured to selectivelyengage corresponding detents 144′ disposed on an outer wall of theelongated portion 140′. The detents 144′ are positioned proximally of araised stop 142′ of the elongated portion 140′.

In use, when the flange 210′ is rotated about the longitudinal axis“A-A” relative to the elongated portion 140′, the projections 216′ ofthe flange 210′ selectively engage the detents 144′ of the elongatedportion 140′; more particularly, at least one projection 216′;selectively engages a corresponding detent 144′. The engagement betweenthe projection(s) 216′ and the detent(s) 144′ helps maintain therotational position therebetween, which can help maintain the positionof the radially-expandable portion 226 of the fixation sleeve 220.Additionally, the raised stop 142′ of the elongated portion 140′ helpsmaintain the longitudinal position of the flange 210′ with respect tothe elongated portion 140′. The radially-expandable portion 226 of thefixation sleeve 220 is either in the first (i.e., non-expanded) positionor the second (i.e., expanded) position.

Referring now to FIGS. 1, 2, 6, 8 and 9 , further details of the anchor250 are shown. The anchor 250 is positionable around the cannula body100 such that the anchor 250 radially surrounds a portion of theproximal sleeve 230. More particularly, the anchor 250 is longitudinallytranslatable along the proximal sleeve 230 between a first position,where the anchor 250 is farther away from the radially-expandableportion 226 of the fixation sleeve 220 (FIG. 6 ), and a second position,wherein the anchor 250 is closer to the radially-expandable portion 226of the fixation sleeve 220 (FIG. 9 ). The anchor 250 can either have africtional engagement with the proximal sleeve 230 such that the anchor250 can be pushed/pulled to move between its first and second positions,or the anchor 250 can be rotationally engaged with the proximal sleeve230 (e.g., a threaded connection) such that the anchor 250 can berotated about the longitudinal axis “A-A” relative to the proximalsleeve 230 to move between its first and second positions.

In use, the anchor 250 is initially in the first or proximal position asthe distal end of the cannula body 100 is being inserted into and/orpositioned within the tissue cavity “C” (FIG. 6 ). Next, theradially-expandable portion 226 of the fixation sleeve 220 is moved toits second, expanded position, and the cannula body 100 is movedproximally such that the radially-expandable portion 226 of the fixationsleeve 220 contacts the distal portion of the tissue wall “T,” forinstance. Then, the anchor 250 is moved toward the second or distalposition such that the anchor 250 contacts a proximal portion of thetissue wall “T,” thereby sandwiching the tissue wall “T” between theanchor 250 and the radially-expandable portion 226 of the fixationsleeve 220 (FIG. 9 ), and fixing the longitudinal position of thecannula body 100 relative to the tissue wall “T.”

The present disclosure also relates to a method of deploying thefixation mechanism 200 of a surgical access device 10. The methodincludes rotating the flange 210 of the fixation mechanism 200 about thelongitudinal axis “A-A” relative to the elongated portion 140 of thecannula body 100 of the surgical access device 10. As discussed above,rotation of the flange 210 causes the radially-expandable portion 226 ofthe fixation sleeve 220 to move between a first, non-expanded position,and a second, expanded position.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as illustrations of various aspects thereof.Therefore, the above description should not be construed as limiting,but merely as exemplifications of various aspects. Those skilled in theart will envision other modifications within the scope and spirit of theclaims appended hereto.

1. (canceled)
 2. A fixation mechanism for use with a surgical accessdevice, the fixation mechanism comprising: a flange defining apassageway, the passageway defining a longitudinal axis; a fixationsleeve extending distally from the flange and including a proximalportion, a distal portion, and a radially-expandable portion; and aproximal sleeve extending distally from the flange and radiallysurrounding the proximal portion of the fixation sleeve, whereinrotation of the flange about the longitudinal axis causes theradially-expandable portion of the fixation sleeve to move between afirst position defining a first gap between the radially-expandableportion of the fixation sleeve and the longitudinal axis, and a secondposition defining a second gap between the radially-expandable portionof the fixation sleeve and the longitudinal axis, the second gap beinggreater than the first gap.
 3. The fixation mechanism according to claim2, further including a distal sleeve radially surrounding the distalportion of the fixation sleeve.
 4. The fixation mechanism according toclaim 2, wherein the radially-expandable portion of the fixation sleeveis disposed between the proximal portion of the fixation sleeve and thedistal portion of the fixation sleeve.
 5. The fixation mechanismaccording to claim 2, wherein the radially-expandable portion of thefixation sleeve is disposed distally of the proximal sleeve.
 6. Thefixation mechanism according to claim 2, further including a distalsleeve radially surrounding the distal portion of the fixation sleeve,wherein the radially-expandable portion of the fixation sleeve isdisposed distally of the proximal sleeve and proximally of the distalsleeve.
 7. The fixation mechanism according to claim 2, wherein thefixation sleeve is made from at least one of mesh or a shape-memorymaterial.
 8. The fixation mechanism according to claim 2, wherein theproximal sleeve is made from at least one of a transparent material or atranslucent material.
 9. The fixation mechanism according to claim 8,further including a distal sleeve radially surrounding the distalportion of the fixation sleeve, the distal sleeve being made from atleast one of a transparent material or a translucent material.
 10. Thefixation mechanism according to claim 2, further including an anchorpositioned proximally of the radially-expandable portion of the fixationsleeve.
 11. The fixation mechanism according to claim 10, wherein theanchor is longitudinally translatable relative to the fixation sleeve.12. The fixation mechanism according to claim 2, further including adistal tip engaged with a distal end of the fixation sleeve.
 13. Afixation mechanism for use with a surgical access device, the fixationmechanism comprising: a flange defining a passageway, the passagewaydefining a longitudinal axis; a fixation sleeve extending distally fromthe flange and including a proximal portion, a radially-expandableportion, and a distal portion; and a proximal sleeve extending distallyfrom the flange, radially surrounding the proximal portion of thefixation sleeve, and disposed proximally of the radially-expandableportion of the fixation sleeve, wherein rotation of the flange in afirst direction about the longitudinal axis causes theradially-expandable portion of the fixation sleeve to move away from thelongitudinal axis.
 14. The fixation mechanism according to claim 13,wherein the proximal sleeve is made from at least one of a transparentmaterial or a translucent material.
 15. The fixation mechanism accordingto claim 13, wherein the fixation sleeve is made from at least one ofmesh or a shape-memory material.
 16. The fixation mechanism according toclaim 13, further including a distal tip secured to a distal end of thefixation sleeve.
 17. A fixation mechanism for use with a surgical accessdevice, the fixation mechanism comprising: a flange defining apassageway, the passageway defining a longitudinal axis; a fixationsleeve extending distally from the flange and including a proximalportion, a radially-expandable portion, and a distal portion; and aproximal sleeve extending distally from the flange and radiallysurrounding the proximal portion of the fixation sleeve, a proximalportion of the proximal sleeve being fixed from longitudinal movementrelative to the flange, wherein rotation of the flange in a firstdirection about the longitudinal axis causes the radially-expandableportion of the fixation sleeve to move away from the longitudinal axis.18. The fixation mechanism according to claim 17, wherein theradially-expandable portion of the fixation sleeve is disposed betweenthe proximal portion of the fixation sleeve and the distal portion ofthe fixation sleeve.
 19. The fixation mechanism according to claim 17,wherein the radially-expandable portion of the fixation sleeve isdisposed distally of the proximal sleeve.
 20. The fixation mechanismaccording to claim 17, further including an anchor positioned proximallyof the radially-expandable portion of the fixation sleeve.
 21. Thefixation mechanism according to claim 20, wherein the anchor islongitudinally translatable relative to the fixation sleeve.